In a tiny room at the Family Support Trust Clinic in Harare, a seven-year-old girl sits on a bench playing with a doll.
Dr Richard-Gray Choto, the paediatrician charged with her care, asks her a question. “Tell me what happened to you,” he says.
She looks down and hesitates for a moment. “Show me what happened to you using the doll you are holding,” he says, trying to coax her into breaking her silence.
The girl is one of tens of thousands of children in Zimbabwe who are believed to have faced sexual abuse in recent years, and Dr Choto knows the experience she is about to recount could leave permanent psychological scars.
His clinic alone says it has treated over 29,000 children for sexual abuse over the past four years; on average 20 children a day.
But this figure, he says, represents just the tip of the iceberg. Many more abused children are simply too scared to ask for help.
“What we can estimate from the statistics is that for every female child that comes here, five haven’t come in or remain anonymous,” he says. “For every male child sexually abused 20 haven’t shown up.”
Child sex abuse is not restricted to girls. Social workers in Zimbabwe say 50 per cent of sexually abused children are boys, but they are much less likely to report their ordeals.
“The male child who shows up shows up because there severe damage has been done or a disease has been transmitted,” Dr. Choto says, adding that most sexual abuse is carried out by a close relative.
The country’s economic crisis has made things worse. Parents are often forced to look for work abroad, leaving their children behind to be cared for by members of their extended family.
Deaths caused by HIV and Aids are another reason why so many children become vulnerable to abuse – the UN estimates that there are one million Aids orphans in Zimbabwe.
Some are forced to move in with extended family, while others are simply left to fend for themselves. Without their parents to protect them, they are especially vulnerable to sexual exploitation.
There are laws in place that are supposed to protect children, making it illegal to have a sexual relationship with a girl under the age of 16, but Zimbabwe’s shaky coalition government does not have adequate resources to tackle the issue.
There are other initiatives; organisations like Childline Zimbabwe, which runs a free telephone and postal service for children who are being abused. But for thousands of children, this is not enough.
Back in the Family Support Trust Clinic, the little girl with the doll finishes her story. She had been raped by a 15-year-old boy while playing hide and seek with her friends.
She does not appear to understand the seriousness of what she has just described, laughing and joking with her mother about a prank her friend had played at school.
Dr Choto shakes his head. Working on the frontline of Zimbabwe’s battle against child sex abuse, he has heard stories like the little girl’s many times before.